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DHS FORMS
ADMINSTRATIVE FORMS
APPEALS & EXCEPTIONS
Form Name |
Send To |
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Submit On-Line |
BACKGROUND CHECKS
Form Name |
Send To |
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Central Abuse Registry
IA Dept of Human Svcs
1305 E Walnut
Des Moines, IA 50319
Fax to: 515-242-6884
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CASH ASSISTANCE
CHILD CARE ASSISTANCE
Form Name |
Send To |
*Multi-program application can be used to apply for Food Assistance, Child Care Assistance, Medical Assistance and Cash Assistance |
County Offices |
CHILD SUPPORT
Form Name |
Send To |
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Collection Services Center
PO Box 9125
Des Moines, IA 50306-9125
Information Only |
FOOD ASSISTANCE
Form Name |
Send To |
*Multi-program application can be used to apply for Food Assistance, Child Care Assistance, Medical Assistance and Cash Assistance |
County Offices |
HEALTH CARE/MEDICAL
Medical Assistance/Medicaid
Form Name |
Send To |
*Multi-program application can be used to apply for Food Assistance, Child Care Assistance, Medical Assistance and Cash Assistance |
County Offices |
hawk-i (Children's Health)
Form Name |
Send To |
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hawk-i Program
PO Box 71336
Des Moines, IA 50325-9958 |
Privacy In Health Care/HIPAA
Form Name |
Send To |
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HIPAA Privacy Officer
IA Dept of Human Svcs
1305 E Walnut
Des Moines, IA 50319 |
Home & Community Based Services (Waivers)
Form Name |
Send To |
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Iowa Finance Authority
HCBS Rent Subsidy
100 E Grand Ave. Ste 250
Des Moines, IA 50309
Your Targeted Case Manager
County Offices |
MANDATORY REPORTER FORMS
Form Name |
Send To |
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County Offices
Central Abuse Registry
IA DHS
1305 E Walnut
Des Moines, IA 50319 |
PROVIDERS
Invoice (All Providers)
Child Care Assistance Providers
Form Name |
Send To |
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County Offices
Dept of Criminal Investigations
Wallace Office Building
Des Moines, 50309 |
In Home Health Related Care Providers
RTSS/POSS Providers
State Payment Plan (Providers)
Form Name |
Send To |
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SPP Manager, BDPS
IA Dept of Human Svcs
1305 E Walnut
Des Moines, IA 50319
County Offices |
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